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• Appearance : Clear
• Pressure (mm water) : 280
• Protein (g/dL) : 60
• Glucose (mg/dL) : 55
• Cells per microlitre : 50 lymphocytes
• Gram Stain : No organisms seen
• 43 year old male was admitted with history of
fever with history of severe headache and
recurrent bouts of vomiting for the past 30 days.
On examination, Kernigs sign and Brudzinsky
signs were positive. A Lumbar puncture was done
and the CSF analysis results are as follows :
•
• Appearance :turbid with cobweb coagulum
• Pressure (mm water) : 320
• Protein (g/dL) :65
• Glucose (mg/dL) : 35
• Cellsper microlitre :500 , L-80%
• Gram Stain : No organisms
32 year old male presented with fever for 1 month ,right sided pleuritic
chest pain and progressive breathlessness. Clinical examination revealed
right sided moderate pleural effusion. Pleural fluid analysis done was as
follows :
– Protein : 6 g/dL
– Albumin : 2 g/dL
– LDH : 150 U/L
– ADA : 72 units/dL
– Microscopy : predominantly lymphocytes
– Gram stain : no organisms seen
– Glucose : 20 mg/dl
– Protein : 3 g/dL
– Albumin : 2 g/dL
– LDH : 90 U/L
– ADA : 20 units/L
– Microscopy : No cells seen
– RBC : Nil
– Gram stain : no organisms seen
– Glucose : 65 mg/dl
– Protein : 6 g/dL
– Albumin : 2 g/dL
– LDH : 150 U/L
– ADA : 10 units/dL
– Microscopy : predominantly neutrophils
• and plenty of pus cells
– Gram stain : Gram positive cocci in clusters
– Glucose : 20 mg/dl
O/E
• Pallor+,sternal tenderness+
• P/A-hepatosplenomegaly+
O/E
• He was conscious
• BP-100/70mmhg
• PR-100/min
• Ecchymotic patches all over his body
• Bleeding from gums+
His lab paramaters are given below
• PT – 22s
• INR – 1.9
• aPTT- 59s
• serum fibrinogen – 50mg/dL(normal 150-400 mg/dL)
• serum FDP - >90mcg/ml(normal <10mcg/ml)
• Platelet count – 50,000/mm3
• 1.INTERPRET THE LAB VALUES
• 2.WHAT IS THE MOST PROBABLE DIAGNOSIS?
• 3.WHAT ARE THE OTHER CAUSES OF THIS CONDITION?
• 4.HOW WILL YOU MANAGE THIS CONDITION
A patient, age 24 years was admitted to the hospital with history of
generalized weakness, fatigue, bleeding from gums, epistaxis and sore throat.
Physical examination showed tachycardia, ecchymotic patches in the upper
limbs, palpation of the abdomen showed no organomegaly.
• Normal values:
• M.C.V - 90(+-)8fl
• M.C.H - 30(+-)3pg
• M.C.H.C - 34(+-)2%
• John a 10 year old boy, suddenly developed puffiness
of the eyelids and facial edema 4 days after developing
sore throat. The urine was dark in colourand scanty,
and the blood pressure was elevated. Urine analysis
showed:
• Investigations:
• S.creatinine : 1.4mg/dl
• Urine examination:
• Sugar : nil
• Protein : 3+
• RBC : 1-2 cells/hpf
• Pus cells : Nil
• Cast : granular , hyaline and fatty casts +